March 8, 2016

Sen. Whitehouse Discusses the Bipartisan CARA Act on the Senate Floor

Mr. President, no one appears to be seeking the floor right now, so I will take the opportunity to speak about our CARA legislation. Since the Senator from Ohio, who has been my partner in this, is now presiding, this is an opportune time to give some remarks.

I think like many States, just from the remarks we heard on the floor already, it is not unusual to have a terrible toll at home from opioid abuse and from overdoses. In 2014, 239 Rhode Islanders lost their lives to overdoses. That is more than were killed in automobile accidents, more than were killed in homicides, more than were killed by suicide. Indeed, that is more than all of those categories–automobile accidents, homicides, and suicides–combined.

In one small community, Burrillville, RI, the beginning of last year was marked by six opioid overdose deaths. Burrillville is a very small town in northern Rhode Island. There are probably 5,000 people who live there. In one quarter, the opening quarter of last year, to lose six people, to have six police calls to the scene, to have six wakes, six funerals in a community that small–that is sadly emblematic of what is going on all around the country.

Rhode Island is not alone. The addiction overdoses are claiming lives, creating tragedy, and destroying families across the United States. Our emergency rooms in America treat almost 7,000 people every single day for the misuse or abuse of drugs. There are 7,000 people who come through the ER doors needing treatment, which, by the way, runs up costs to our health care system. More than 120 people die every day as a result of an overdose. The latest year for which we have figures is the year that Senator Thune just mentioned, 2014–47,000 dead in 1 year.

If you leave this building and walk down to the Mall, you will find the Vietnam War memorial. The Vietnam War memorial has about 58,000 names on it. From the entire Vietnam conflict, there are 58,000 names on the Vietnam War memorial. From 1 year of opioid overdose, there are 47,000 deaths. I am afraid it probably went up in 2015. We don’t have the figures in yet.

Behind this tragedy of death and sorrow lies a terrible failing, which is that, according to the most recent estimates, nearly 9 out of 10 people who need drug treatment don’t get it. They just don’t get it. When you think of that death toll, you think of the cost and you think of the sorrow. The idea that we are still letting 9 out of 10 people who need treatment not even get it, not have access to it, is a terrible failing.

The economic cost of all of this is something we always think about here in Congress. Whether it is from health care costs or criminal justice-related costs or loss of productivity at work, that has been estimated at as much as $70 billion per year.

One thing we have seen is that the ongoing substance abuse epidemic does not discriminate by race, by ethnicity, by gender, or by age. Overdose rates are up in both men and women, in non-Hispanic Whites and Blacks, and in adults of almost all ages. The dynamic nature of this epidemic demands that we respond in a comprehensive way–a way that brings together the public health, the public safety, the behavioral health care, the addiction recovery, and other communities.

It was out of this recognition, this realization that this pandemic, as some have aptly called it, requires an all-hands-on-deck approach that the Comprehensive Addiction and Recovery Act was born. Starting in the spring of 2014, Senator Portman of Ohio, Senator Klobuchar of Minnesota, Senator Ayotte of New Hampshire, and I hosted a series of bipartisan, bicameral congressional forums addressing various aspects of addiction–from the role of addiction in our criminal justice system, to the special challenges faced by women, by veterans, by young addicts, and the collateral consequences that we impose on people when they are in recovery. We hosted five forums, as the Presiding Officer will well recall, that brought together experts from these various fields to come here from all around the country. This was a national pilgrimage to Washington to highlight best practices and to share success stories from their States.

Mr. President, I will continue my remarks.

We were discussing the forums that the Presiding Officer, Senator Ayotte, Senator Klobuchar, and I organized. Out of that developed a national working group of stakeholders from the public health community, from behavioral health folks, prevention, treatment, recovery, and law enforcement. The forums informed us and the working groups supported us as we worked to draft legislation that would promote effective, evidence-based policies and increase collaboration among what are too often siloed areas of activity and expertise.

The bill we developed would do a great number of things. They fall into four major categories:

First, it would expand prevention and educational efforts–particularly aimed at teens, parents, and other caretakers, and elderly folks, aging populations–to prevent the abuse of opioids and heroin and to promote treatment and recovery.

Second, it would expand the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses and save lives.

Third, it would expand the resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment.

Fourth, it would strengthen prescription drug monitoring programs to help States monitor and track the diversion of prescribed drugs out of the proper and legitimate market and to help at-risk individuals get access to the services they need.

It does a number of other things, but I will not summarize them all now.

The Comprehensive Addiction and Recovery Act recognizes what we have learned from science and from experience, and it promotes those practices that we know work best to confront the multiple facets of this new epidemic. It sends the message that we in Congress understand that addiction is a disease, a public health crisis that requires more than the enactment of stiffer criminal penalties. We tried that road. We know it was not a success.

The bill we worked on and prepared has been endorsed by over 130 community and national organizations on the frontlines of this epidemic, including the National Council on Behavioral Health, Community Anti-Drug Coalitions of America, the Hazelden Betty Ford Foundation, the National District Attorneys Association, the National Association of Attorneys General, major county sheriffs, the American Correctional Association, and many others.

Here in the Senate, at the last count, we had 38 cosponsors and myself. I am sure that number is climbing.

As committed as I am to the principles in this legislation and to the need to encourage and support these policies, I recognize that this bill alone is not enough. Without adequate resources to fund the programs in the Comprehensive Addiction and Recovery Act, CARA, they will remain out of reach to too many of the individuals, communities, and first responders who most need them. Without adequate resources for prevention, treatment, and recovery, we will continue to spend billions of dollars elsewhere in economic and societal costs that would be avoidable if we got this right. Without adequate resources, too many people who desperately want to turn their lives around will be told to wait another day.

Anybody who knows about addiction recovery knows what the consequences can be of being told to wait another day.

Senator Shaheen of New Hampshire has proposed an amendment which provides emergency appropriations to address this crisis. I am a cosponsor of that amendment because I agree with her that the opioid epidemic is an emergency, a public health emergency, and should be treated as one. Building on the strong commitment Congress made to funding addiction and recovery programs in the fiscal year 2016 omnibus, Senator Shaheen’s bill would appropriate an additional $600 million to the Department of Justice, to SAMHSA, and the CDC, much of it going to programs authorized in CARA, the Comprehensive Reduction Recovery Act, or complementary to CARA’s goals.

This would not be the first time the Congress has authorized emergency spending in response to a public health emergency. When the swine flu epidemic hit, and I believe took 11,000 lives, Congress appropriated $2 billion on an emergency basis with broad support on both sides of the aisle. Here, in the latest year for which we have the data, the body count is 47,000 deaths. We lost 11,000 lives to swine flu and 47,000 lives in 1 year to the opioid epidemic.

I hope my colleagues on both sides of the aisle will join me and Senator Shaheen and vote, not only to support the Comprehensive Addiction and Recovery Act but to also provide added resources to make those principles a reality in the lives of the people who are counting on us to come to their aid. Addiction is a tough illness and recovery from it is a hard but noble path. Men and women who walk that path deserve our support, encouragement, and admiration.

I thank my fellow sponsors, Senator Portman, Senator Klobuchar, and Senator Ayotte, for their partnership over the past 2 years as we prepared this legislation. I thank Chairman Grassley and my ranking member Senator Leahy for their commitment to tackling this epidemic and for bringing this bill out of the Judiciary Committee without opposition and now to the floor where we hope we can bring it across the finish line.

Let me say that I anticipate we are going to have a disagreement about the funding of this bill. I will fight as hard as I can to make sure this bill is adequately funded, but I do not intend, nor do I know anyone who intends, to block the passage of CARA or to interfere with it going into law over the question of funding.

People will have to check in with their own consciences, check in with the desires of the addiction and recovery communities in their home States, and check in with their constituents as to the right way to vote on giving this adequate funding.

Finally, let me close by thanking the advocates, providers, police officers, rescue personnel, and of course the families who support and help the people in recovery through the tough nights and days. They do the hard work of saving lives every single day, and we would do well to honor them by passing this bill and seeing to it that it has adequate funding support.

I yield the floor to the Senator from Virginia.